Pleuritis caused by nontuberculous mycobacteria is uncommon and difficult to diagnose. We herein report a case of Mycobacterium avium complex (MAC) pleuritis with elevated anti-glycopeptidolipid (GPL)-core IgA antibody levels in the pleural effusion. A 73-year-old woman with MAC pulmonary disease presented with massive left pleural effusion. A pleural biopsy by video-assisted thoracoscopic surgery was performed, revealing many noncaseating epithelioid cell granulomas. MAC was not identified by culture of the pleural effusion or specimens, but the anti-GPL-core IgA antibody level was markedly elevated in the pleural effusion. Measurement of anti-GPL-core IgA levels in the pleural fluid may be useful for diagnosing MAC pleuritis.
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http://dx.doi.org/10.2169/internalmedicine.2751-19 | DOI Listing |
Am J Emerg Med
January 2025
Division of Critical Care Medicine, Western University, London, ON N6A 5C1, Canada.
Rationale: Lung ultrasound, the most precise diagnostic tool for pleural effusions, is underutilized due to healthcare providers' limited proficiency. To address this, deep learning models can be trained to recognize pleural effusions. However, current models lack the ability to diagnose effusions in diverse clinical contexts, which presents significant challenges.
View Article and Find Full Text PDFHemorrhagic pleural effusion as the sole manifestation of pancreatitis is exceedingly rare and often presents diagnostic challenges due to its misleading symptoms. We report the case of an adult male with a large left-sided black pleural effusion secondary to chronic necrotizing pancreatitis. The patient presented with progressive shortness of breath and cough, with a history of alcohol use and a previous diagnosis of acute severe pancreatitis.
View Article and Find Full Text PDFIntroduction: Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) is a severe hypersensitivity reaction rarely documented in patients with multiple myeloma (MM).
Methods: In our retrospective study of 108 newly diagnosed MM (NDMM) patients from January 2021 to October 2023, we identified four cases of DRESS. The clinical characteristics such as clinical manifestations, laboratory results, treatment and outcome were analyzed.
Respir Med Case Rep
January 2025
Thoracic Medicine and Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, United States.
Pancreatopleural fistulas, rare complications of chronic pancreatitis, are often overlooked in the initial differential diagnoses of pleural effusions, resulting in delayed diagnosis and management. We present the case of an elderly male with recurrent pleural effusion and a history of chronic pancreatitis. Diagnostic challenges arose, with the initial misdiagnosis as pneumonia.
View Article and Find Full Text PDFActa Radiol
January 2025
PET-CT Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shannxi, PR China.
Background: Computed tomography (CT) is the most common way to evaluate focal organizing pneumonia (FOP); however, sometimes it is difficult to differentiate FOP and peripheral lung carcinoma (PLC).
Purpose: To clarify the MRI manifestation of FOP and the value of MR in the differential diagnosis of FOP and PLC in comparison to CT.
Material And Methods: Chest MR (3D T1WI, T2WI TSE, DWI) and CT images of 72 patients (50 men: mean age=64.
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